Psychological Toll Revealed: Fear of Cancer Recurrence High Among Survivors of Localized Cutaneous Melanoma

The surge in cutaneous melanoma incidence, primarily presenting as a localized disease with favorable surgical outcomes and high survival rates, has prompted an exploration into the psychological well-being of survivors, an aspect that remains relatively unexplored. The study underscores the profound psychological impact and heightened fear of cancer recurrence among survivors of localized cutaneous melanoma, including those with stage 0 diagnoses.

The study results were published in the journal JAMA Dermatology.

While the United States has witnessed a rapid rise in the incidence of cutaneous melanoma, the majority of cases have manifested as localized disease, managed through surgical interventions with high rates of survival. Despite these positive clinical outcomes, there remains a significant gap in our understanding of the psychological well-being of melanoma survivors in the U.S. The objective of this qualitative and survey-based study was to delve into the lived experiences and fear of cancer recurrence among individuals who had faced localized cutaneous melanoma.

Conducted at an academic dermatology practice affiliated with the University of Texas, Austin, the research employed semi-structured interviews and utilized the Fear of Cancer Recurrence Inventory short form (FCRI-SF) survey tool. From August 2021 to September 2022, researchers conducted interviews, either in person or via telephone, with 51 participants who had a history of localized melanoma (stage 0-IIA). The study cohort, with a mean age of 49.5 years, comprised 67% females and 33% males. Among the participants, 33% had survived stage 0 melanoma, while the remaining individuals had experienced at least one invasive melanoma diagnosis (stage I-IIA).

Findings:

• The semi structured interviews revealed four distinct themes: emotions surrounding follow-up appointments, the intensity of melanoma surveillance, lifestyle changes related to sun exposure, and contemplations about life and death.
• Notably, despite the generally favorable prognosis associated with localized melanoma, the Fear of Cancer Recurrence Inventory short form (FCRI-SF) survey results were striking.
• Of the 51 participants, 38 scored above the threshold indicating clinically significant fear of cancer recurrence.

In conclusion, this study sheds light on the psychological impact and fear of cancer recurrence experienced by survivors of localized cutaneous melanoma, even among those with stage 0 diagnoses. The findings emphasize the need for a comprehensive understanding of the survivorship experiences and psychological well-being of individuals with melanoma, prompting further research and potential interventions to address the unique challenges faced by this population.

Further reading: Mahama AN, Haller CN, Labrada J, et al. Lived Experiences and Fear of Cancer Recurrence Among Survivors of Localized Cutaneous Melanoma. JAMA Dermatol. Published online February 14, 2024. doi:10.1001/jamadermatol.2023.6158